Taylor Ellsworth, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12152 Issued in GA

Practice address

1462 Clifton Rd NE Ste 280
Atlanta, GA 30322-1063

Phone

(404) 727-7825

NPI assigned

Sep 22, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Emory University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grady Memorial Hospital CorporationGroup PAC ID 7517032998, 365 clinicians

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grady Memorial Hospital Hospital, Atlanta, GA, CCN 110079
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grady Memorial Hospital Corporation

  dba Grady Health System

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1114243813
  Medicare reassignment Care Compare group NPD
• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD
• Grady Memorial Hospital Corporation

  dba Grady Inpatient Rehabilitation Unit

  • Rehabilitation Hospital
  • Atlanta, GA
  • NPI 1336961119
  NPD
• Grady Memorial Hospital Corporation

  • Multi-Specialty Clinic/Center
  • Atlanta, GA
  • NPI 1649765686
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grady Memorial Hospital Corporation

  dba Grady Health Systems

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1992799050
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital Cherokee

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1700509809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1462 CLIFTON RD NE STE 280",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221063",
            "telephone_number": "404-727-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1462 CLIFTON RD NE STE 280",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221063",
            "telephone_number": "404-727-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12152",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Alec Ellison Jr.
• Sara Ellison, APC, NCC
• Ellsworth Foot and Ankle Clinic (Summit Foot and Ankle)
• Michael Ellsworth, PAA
• Ryan Scott Ellsworth, DPM
• Delilah Ellzey, PHD
• Andrew Elmer
• Jillian Elmer
• Caitlyn Sue Elmes, PHARMD
• Therese Elmore-Christian

• Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.